Everyday Oral Surgery

Residency is the perfect learning environment for young maxillofacial surgeons, with valuable skills and know-how shared among professors and peers alike. Once qualified, the transition into private practice or starting a practice of your own can be quite daunting. Our guest today is an old-time friend and expert maxillofacial surgeon, Dr. William “Billy” Hull, who has plenty of guidance to share. To kick things off, we take a look at Billy’s academic and professional history. Having studied at The University Of Illinois At Chicago Medical Center, he has since moved into various private practice settings and is now a partner at his own practice. From picking the right partners to the best way you can build functional working relationships with them, Billy shares his biggest lessons with us. He then dives into seniority, hierarchy dynamics, and the best ways to manage compensation, before providing insight on why you should move into an established practice for your first gig. As our conversation continues, Billy talks about how he has evolved as a surgeon, telling us about his favorite tools and the reasons he uses them. Sprinkled throughout our conversation, Billy reminisces about his old days in residency, offering comical anecdotes and explaining why humor is an important part of his job. Remember to floss and be sure to tune in!Key Points From This Episode:Introducing today’s guest, maxillofacial surgeon Dr. William “Billy” Hull.Billy shares details about his professional history.Hear about the lessons Billy has learned over the years.How hierarchy can influence the success of a practice. Exploring the pros and cons of having a good partner.Why the relationships you build during residency are so important.The art of drawing up a partnership contract that fairly distributes compensation.Knowing what healthy competition is between partners.Hear Billy’s humorous anecdotes about his residency.Billy tells us how he has evolved as a surgeon since leaving medical school.Why spreading your legs can be better than bending over while performing surgery.Billy touches on why he won’t use a hall drill.Hear about the 703 and its finesse as an oral surgery tool.Find out how Billy’s incision design has changed over the years.Why PRF is preferred over dry-socketing. Billy’s preference of BioHorizons over Straumann and Nobel Biocare.Hear about how Billy keeps a balance between humor and professionalism.Links Mentioned in Today’s Episode:Dr. William Hull on LinkedIn.The University Of Illinois At Chicago Medical CenterBioHorizonsNobel BiocareStraumann

Talking less and listening more empowers your patients and helps you better serve their needs. This insight is provided by Dr. Justin Evanson of Pacific Dental Services. Today we speak to Justin about his work as an Oral and Maxillofacial Surgeon, what he’s done to overcome his challenges, and the ways that he’s improved his practice. We open our conversation by exploring his training and the procedures that he most commonly administers. He dives into what he has recently changed to make his daily routine better, including the new additions to his surgical kit. After talking about the benefits of a new suturing technique, we discuss why he prefers healing abutments to cover screws, and why Justin rarely conducts upper molar immediate implants. We ask Justin how he follows up with patients who have other dental providers, his answers highlighting the importance of communicating with both patients and their providers. We then touch on his approach to anesthesia which leads to Justin explaining how he quickly builds connections with his patients. Near the end of the episode, Justin reflects on his two most difficult cases and what he did to get through them. Tune in to hear more of Justin’s top tips on improving your oral surgery practice. Key Points From This Episode:We introduce today’s guest, Oral and Maxillofacial Surgeon Dr. Justin Evanson. Hear about Justin’s training at Parkland Hospital in Dallas, Texas.Justin shares details about his current practice and the procedures he often performs. Top tips from Justin on how you can improve your surgery.Using the figure-eight suturing technique developed by Dr. Daniel Buser. Swapping out different sized healing abutments over time. Why Justin rarely does upper molar immediate implants. Follow-up and dealing with patients who have other dental providers. Justin’s philosophy on anesthesia and how he applies it with patients. Exploring the most challenging aspects of Justin’s daily routine. How you can develop a connection with patients that you only see once or twice. Why Justin doesn’t talk people into procedures that they have reservations about. Offering quality care to all of your patients — even if that means long appointments. Details on Justin’s two most difficult cases and how he got through it.Justin shares some final practical advice to help listeners in surgery. Links Mentioned in Today’s Episode:Dr. Justin Evanson on LinkedInPacific Dental ServicesColumbia UniversityParkland Hospital UT Southwestern Medical CenterJohn Peter Smith HospitalBien AirVersahDr. Daniel Buser International Team for ImplantologySalvin Dental Specialists BaxterDigital Dental SolutionsZack ReynoldsNobel BiocareDr. Grant Stucki Contact — 720-775-5843

As a small community, oral and maxillofacial surgeons need to share what they have learned to ensure everyone's practice thrives. In today’s show, Dr. Raza Hussain gives us insights into the knowledge he has gained through both his academic and faculty surgery work. Raza practices in Chicago, where he is the Chief of Oral and Maxillofacial Surgery at the Jesse Brown Veterans Administration Medical Center. We dive right in, discussing Raza’s approach to dealing with peri-implantitis, where he shares why he uses the controversial implantoplasty as a treatment and the importance of collaborating with the restorative doctor. We then hear about the most difficult cases Raza has encountered working at a VA hospital. From transmandibular implant removal to necrotizing fasciitis, Raza has handled incredibly unique cases that many oral and maxillofacial surgeons are unlikely to encounter over the course of their careers. The conversation then moves onto protecting oral and maxillofacial surgeons’ outpatient anesthesia rights and why the current campaign to remove these rights is unfounded. Raza acknowledges that support staff might not be well-trained, but he believes that it is the practicing surgeon's responsibility to get his team on the same page. He shares what those of us in private practice can do to ensure we will continue to be allowed to do jobs in a way that is best for our patients. To hear this and more, be sure to tune in today!Key Points From This Episode:Get to know Raza, his professional experience, and what he’s up to now. The improvements that Raza has made with his implants over the last few years.What Raza does with implants that have two or three threads exposed on the buccal.Why Raza uses an implantoplasty to treat implants that have deteriorated.The level of bone loss or peri-implantitis which prompts Raza to intervene.The importance of having a good relationship with the restorative doctor when treating peri-implantitis.Patients are unlikely to change their habits, so surgeons should try new techniques.Hear why removing transmandibular implants is so difficult.Insights into the trickiest case Raza has had to treat that involved necrotizing fasciitis.Why Raza has not changed his third molar extraction technique much over the years.Coronectomy versus piezo: Which technique results in greater complication.Tried and trusted methods; why Raza sticks with a regular course of antibiotic treatment for third molar extractions.How Raza’s anesthetic technique has changed seeing as his wife is an anesthesiologist.Why trying to take oral surgeons’ right to outpatient anesthesia is misguided.Raza’s firm approach to putting patients to sleep and why he does not tolerate joking around at that time.The bad press that oral and maxillofacial surgeons get when anesthesia goes wrong.Negative outcomes of not allowing oral and maxillofacial surgeons to administer anesthesia.What oral maxillofacial surgeons in private practice can do to support the profession’s rights.The complications that Raza has seen with TMJ disorders and his preferred courses of treatment.Links Mentioned in Today’s Episode:Dr. Raza HussainUniversity of Illinois at Chicago (UIC) College of DentistryJesse Brown VA Medical CenterAAOMS

In this solo episode with your host Dr. Grant Stucki, listeners will hear all about avoiding the mistake of taking out the wrong tooth. While this is not a glamorous topic, it is still an important one since too many patients have left their dentist’s office with the wrong tooth missing. Very little is said and taught on this issue because it seems like such a simple thing to get right. In general surgery, doctors initial the area of the body that will be operated on to ensure that everyone is on the same page and the right part of the body is identified. Even so, there have been instances where a patient who needed a hip replacement left with a tendon repair they didn’t need, so removing the wrong tooth is not so far fetched. Just the idea of making this mistake puts some oral surgeons in a low-grade seizure state, especially if they’ve come close to this experience. Today Dr. Stucki shares examples of some of the cases where you might be more likely to make a mistake or be distracted and discusses some of his trusted procedures to ensure that he gets the right tooth every time. Key Points From This Episode:Dr. Stucki shares his experience of taking out the wrong tooth during his residency training. How difficult it was for him to get over the mistake and how affected his confidence level. The identifiers he looks for on the referral notes to ensure that he works on the right tooth. Checking the financial agreement to see which procedures have been signed and paid for. The procedure he walks through with every patient to identify and verify the right tooth.  What Dr. Stucki does right before he begins working on the tooth.The importance of the surgeon, patient, and assistant being on the same page. Awareness of scenarios and cases in which you are more likely to remove the wrong tooth. What plowing down cactuses in Tucson, Arizona, and today’s topic have in common. Examples of high-risk cases for taking out the wrong tooth, including two impacted molars. What you can do to ensure that you have identified the correct supernumerary tooth.  How time constraints can contribute to you confusing patients and cases.Internal and external distractions that can give way to mistakes during surgery.

Today Dr. Stucki interviews Dr. Scott Weiskopf, an oral and maxillofacial surgeon practicing in Tennessee in the Memphis area. Ever since he introduced a fully digital workflow and started printing his own surgical guides, his dental surgery practice has been transformed because it allows him to produce and place top-quality implants. In this conversation, Dr. Weiskopf shares how his appointments with patients who need implants typically proceed, when in the process the guides are made, and the handful of cases where placing the implant freehand is still better. Tuning in, listeners will get a sense of the cost implications of printing the guides yourself, how it benefits your patients and practice, and where you can purchase the cheapest – yet effective – 3D printing equipment. Our guest shares details on his grafting techniques and materials, how he approaches third molar extractions, and what he favors in terms of instruments. The two also discuss drugs and dosages and share a bit about their work philosophies. Key Points From This Episode:What switching over to a fully digital workflow meant for his dental surgery practice. The benefits of having surgical guides when doing implants.Get a sense of how the appointments proceed for implant consultations and surgery. The cost implications of printing the guides yourself rather than having it printed by a big lab. Where you can purchase a 3D printer and why you don’t need a dental-specific one. Dr. Weiskopf talks about the handful of times he has had to adjust the guides. Learn why he works almost exclusively with the Straumann Dental Implant System.    What his grafting technique looks like and why he switched to a different membrane. Dr. Weiskopf’s graft materials of choice, including allograft, xenograft, and DBM putty. How using the guides differs from placing the implants freehand and when the latter is more appropriate. The benefits of having patients see and ask about the latest in dental technology. How your software determines the ease with which multiple implants can be created. Learn what has changed in his third molar extraction technique since his residency. Dr. Weiskopf talks about his preferred tools and why he picks up the instruments himself. The value of having a second assistant and what his typical drugs and dosages involve. The idea that when you permit something, you are inadvertently promoting it. Links Mentioned in Today’s Episode:Dr. Scott Weiskopf Straumann Dental Implant System Nobel BiocareBioXclude 

As surgeons, we must ensure the highest and best use of our time, and an important part of this is creating systems and delegating unnecessary duties. Joining us today to share his insights on this is Dr. Thomas Sarna, an oral and maxillofacial surgeon, based in Fayetteville, Arkansas, and one of Grant’s mentors during residency. In this episode, Thomas walks us through some of his systems and the tasks he no longer does, including fielding calls, pre or post-op preparations and briefings, and calling around for referrals. Although creating structures and processes takes a lot of work and training on the frontend, once staff is up to par, surgeons have much more energy to do what they love, and ultimately create the most efficient practice possible. We also touch on communicating risks with clients and balancing being transparent with ensuring the patient remains comfortable and at ease. Thomas shares his approach and what he believes is the right amount to share. Along with this, we discuss the use of technology in Thomas’ practice and why he still prefers to take hand-written notes, how he handles communicating with difficult parents or patients, and the importance of knowing your staff’s strengths and weaknesses and drawing on them accordingly. It was a great conversation, and there is always so much to learn from one another's practices. To hear more, be sure to tune in today!Key Points From This Episode:How creating systems to delegate duties has changed Thomas’ practice.The benefits of confirming patient appointments and improvement in efficiency.Why Thomas does not give his cell number to patients and leaves his assistants to field calls.Hear more about what Thomas’ schedule looks like and how COVID has affected it.The brief nature of Thomas’ consults and what he tells the patients.Walking patients through options if numbness is a concern when the root is in the same place as the nerve.Thomas’ approach to communicating risk with patients.Following the acute versus chronic rule when it comes to sinus perforation repair.Using the buccal fat pad method and training NTs how to do it.‘Good’ patients versus ‘bad’ patients and how Thomas thinks about this.The story behind why Thomas calls his difficult procedures ‘The Grant Stucki Clinic.’Some of the best things Thomas learned in residency that he carried into practice.Knowing your staff’s strengths and weaknesses and placing them in the right position.Instances of difficult communication with parents and patients Thomas has had.Why Thomas prefers doing wisdom teeth over implants.The frustration that both Thomas and Grant feel at patients constantly being on their phones.The use of tech in Thomas’ practice, including a cloud-based EMR.Why Thomas still takes notes by hand which then gets digitized after.Hear why Thomas has sedated patients sitting up rather than lying down.Take your wisdom teeth out when you are a teenager!Communicating wisdom teeth removal post-op care instructions.Why not using antibiotics is ‘career suicide’ according to Thomas.Links Mentioned in Today’s Episode:Dr. Thomas SarnaDr. Scott WeiskopfGoogle GlassHow to Win Friends & Influence PeopleThink and Grow RichDr. Grant Stucki

Although residency training can be comprehensive in many ways, it is vital to find what works for you as a surgeon once you are in practice. Today’s guest, Dr. David Salomon, has done just that, tweaking his anesthesia technique over time to administer it efficiently, in the least resource-heavy way possible. As a prestigious doctor working in Connecticut, David runs a successful private practice. In this episode, David talks about why he has mostly stopped using fentanyl and the results he has seen from making this change. While David has been open to changing his anesthesia technique, he also recognizes that it is not possible to have a one-size-fits-all plan for every patient. He talks about developing your intuition to understand what a patient needs. We also learn more about David’s grafting technique, some of the tweaks he is currently making, and the outcomes so far. We then turn our attention to the practice side of things, where David talks about some of the daily difficulties he faces, the role his assistants play and how he handles their training, and the importance of communicating and managing expectations. Not only is David an excellent surgeon technically, but the care and empathy he extends to his patients really sets him apart. To hear more from this inspiring doctor, be sure to tune in today!Key Points From This Episode:Some of the small things David has changed in his practice that have had a big impact.David’s grafting technique and how it has evolved over time.Two things David has noticed about nylon sutures compared with chromic and vicryl sutures.The differences between mineralized and demineralized bone grafts.Techniques David is implementing from Bone Augmentation in Implant Dentistry.Why David does not do that many immediate implants.What David has seen with how some patients get inflamed after a bone graft.How David manages patients’ pain and how he guides them through it. David’s typical sedation protocol and his approach to optimizing the process.How David handles children and adults who are afraid of needles.The most challenging things that come up in David’s daily practice.Why David usually does not sedate children and what he does instead.David’s interest in music, the band he was in for years, and playing songs during surgery.How David has trained his assistants and his emphasis on self-sufficiency.Why David prefers to grab his own tools and do the sutures himself.Benefits of waiting until the end of a procedure to do the sutures.The role an office manager can play in managing assistants and dealing with issues.Keeping lines of communication open and how this counteracts drama with staff.The importance of being a good listener and making patients feel heard and understood.Communicating potential risks in a more human way and how David tackles this.How an empathetic approach can help with even the most difficult patient.The question David asks to break the ice when he meets clients for a consult.David's positive experience of residency and the feeling of camaraderie he misses.Links Mentioned in Today’s Episode:Dr. David SalomonBone Augmentation in Implant DentistryPickles PubDr. Grant Stucki

Dr. Eric Blamires, an oral and maxillofacial surgeon from Colorado, shares his insights on surgical techniques and patient management. He emphasizes the importance of surgeon ergonomics and personal health for longevity in the field. Eric discusses practical ways to build rapport with patients, especially teens, in busy settings. He also dives into streamlined wisdom tooth extraction methods and his approach to suturing and grafting, along with strategies for managing helicopter parents during procedures. Tune in for valuable tips!

Have you ever been at a conference where you heard an intriguing technique or tip from a fellow oral and maxillofacial surgeon or dentist that you then implemented effectively in your practice? We know we have. Welcome to the Every Day Oral Surgery podcast, where we hope to share some techniques and personal experiences that could be beneficial to your surgical or dental practice. In this episode, host, Dr. Grant Stucki, introduces himself, where we learn more about his professional and personal life. He also shares the story of how a lower back injury from playing basketball in college plagued him for years after school and well into his practice. We hear how changing sides has helped alleviate his pain. While this may seem like a small tweak, it is not easy because not only will you be slowed down, but you will have to work on strengthening your weaker hand. Oral surgery and dentistry, in general, can be particularly hard on the lower back, so even if you are not in pain yet, it is well worth taking preventative measures to ensure you remain pain-free. We look forward to many more conversations, so be sure to tune in for the start of this exciting journey!Key Points From This Episode:The goal of this podcast – To share practice techniques that can potentially help yours.A quote from Better, a great book about the meaning of being a surgeon.Get to know Grant, his education and training, and his full-on family life.Playing ‘morning ball’ while at UCLA and how Grant’s signature fadeaway led to an injury.The extent of Grant’s injury which he found out after a triathlon and treatments he followed. Some challenges that came with switching sides and how Grant strengthened his left hand.The benefits that Grant has seen from switching sides, including reduced back pain.Even if you do not struggle with back pain, take preventative measures before it happens.Why surgeons might be hesitant to switch sides.What studies have shown about dentists and lower back pain? Links Mentioned in Today’s Episode:Dr. Grant StuckiDr. Grant Stucki on LinkedInBetter: A Surgeon's Notes on PerformanceAtul GawandeUCLA School of DentistryUniversity of Illinois at ChicagoMichael JordanKarl MaloneHakeem OlajuwonLeBron JamesKobe BryantDirk NowitzkiIronman TriathlonPubMed